1144838939 NPI number — PROFESSIONAL HOME HEALTH CARE, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144838939 NPI number — PROFESSIONAL HOME HEALTH CARE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PROFESSIONAL HOME HEALTH CARE, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1144838939
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/21/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1629 HARVARD ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LONGMONT
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80503-2219
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
720-494-0190
Provider Business Mailing Address Fax Number:
720-864-2839

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3495 WADSWORTH BLVD STE 300B
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WHEAT RIDGE
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80033-4606
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-368-1999
Provider Business Practice Location Address Fax Number:
303-368-8221
Provider Enumeration Date:
07/17/2020

Additional Information

Authorized Official

Authorized Official Last Name:
BELLINGER
Authorized Official First Name:
SHERYL
Authorized Official Middle Name:
ANN
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
720-530-5492

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 253Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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